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Objective: To determine the most effective time to administer nutrition education to hemodialysis patients by evaluating memory recall scores before, during, and after treatment.
Design: Prospective, quasi experimental cohort.
Subjects: Sixty-two adult Hispanic hemodialysis patients (38 men and 24 women, 29 <65 years of age and 32 >65 years of age). Patients, between 18 and 85 years of age, who have been on hemodialysis at least one month. Patients were literate and able to see and hear without impairment.
Setting: Hemodialysis clinic.
Intervention: Fifteen simple words (English and Spanish) in large print on 5 x 8 laminated 2-sided cards that were shown to the patient before, during, and after dialysis.
Methods: Patients were shown 5 different words before going on dialysis, 5 more words during dialysis, and 5 more words after dialysis. Each time, the patient was asked for immediate recall to assess short-term memory recall. Patients were then asked 5 to 10 minutes later (before, during, and after dialysis) what words were seen to assess long-term memory recall.
Main Outcome Measure: Did patients remember more before, during, or after dialysis?
Results: There were no significant differences in memory recall scores between diabetic and nondiabetic subjects or by gender with respect to memory recall scores. Results imply that time of recall in relation to dialysis treatment may be important for those above 65 years of age. A significant difference was found when comparing those subjects completing elementary school to those subjects completing high school and college. The evidence found in this study was in accordance with the findings of Smith and Winslow in their 1990 study showing subjects required less time to complete a task measuring cognitive function when it was given before hemodialysis treatment, as compared with during the treatment.
Conclusion: As age increases, recall ability likely will decrease. As education level increases, recall ability will likely increase. Providing nutrition education before the hemodialysis treatment occurs may be more beneficial than during and after the treatment. The educational information that a hemodialysis patient retains after treatment may be seriously impacted by the patient's education level and age.
